Provider Demographics
NPI:1659042349
Name:BIGLEY, JAMIE (SLP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:BIGLEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 W CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-5906
Mailing Address - Country:US
Mailing Address - Phone:308-850-5487
Mailing Address - Fax:
Practice Address - Street 1:5810 SCARRITT AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64123-1532
Practice Address - Country:US
Practice Address - Phone:308-850-5487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020035039235Z00000X
MO14230232235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOCFOtherSTATE LICENSURE